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What are the risks of liver disease?

Children may present with jaundice and recover completely or progress to cirrhosis. In adults, liver disease is often undetected until cirrhosis or hepatocellular carcinoma are evident.

National Center for Biotechnology Information – Liver Test Results Do Not Identify Liver Disease in Adults with α-1 Antitrypsin Deficiency – Published online 2012 Jul 24

The reported variation in onset and severity of hepatocyte damage also suggests other genetic and environmental factors modify an individuals’ risk of developing liver disease. 

National Center for Biotechnology Information – Liver Test Results Do Not Identify Liver Disease in Adults with α-1 Antitrypsin Deficiency – Published online 2012 Jul 24

…those at highest risk to be the most severely liver affected have metabolic syndrome or some components of metabolic syndrome (diabetes, obesity, belly fat, hypertension, etc.) Those things make your Alpha worse.

Alpha-1 Antitrypsin Deficiency 101; Liver Disease (37min video – 36 minute mark) – Virginia Clark, MD Associate Program Director, Transplant Hepatology Fellowship Assistant Professor of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Florida

Of newborns and children who have two defective AAT genes, such as ZZ, about 1 in 20 will, in their first year, develop liver disease that may be serious. Other children may have abnormal liver blood tests and few symptoms of liver disease. In most cases, the liver abnormalities resolve by the time the child reaches their teens and many ZZ children remain completely healthy. Adults with Alpha-1 can also develop liver disease, which often becomes more severe in middle age and beyond.

Cirrhosis, or scarring of the liver, is the most common liver disease in adults related to Alpha-1. The risk of chronic disease in MZ carriers is much less than that of people with Alpha-1. Research suggests that chronic liver disease might appear in MZ carriers only when the liver has been damaged first by something else. Things that could harm the liver are a virus, such as hepatitis B or C, or a chemical such as alcohol. There is no scientific evidence that carriers with the MS genes are at increased risk for liver disease.

The Liver and Alpha-1Alpha-1 Foundation